Donna Cross

Social anxiety, peer victimisation, and social support are key issues during mid-childhood that provide important influence in the later adolescent years. While extensive research has evaluated these constructs in isolation and during adolescence, almost no longitudinal studies have evaluated relationships between them during mid-childhood. The current study obtained self-report measures of social anxiety, peer victimisation, and social support from a close friend, from 7846 students from grades three and four (M age = 9.01 yr), on three occasions over two years. Path analyses examined mediating and moderating relationships, as well as moderation by binary gender. There was minimal moderation by gender on any of the relationships between variables. Over time, there was a stronger positive prediction from social anxiety to later victimisation (β’s = 0.09–0.12) than from victimisation to later social anxiety (β’s = 0.04–0.07). Social anxiety negatively predicted later social support (β’s = −0.05 to −0.09), but social support did not consistently predict later social anxiety (β’s = −0.01 to −0.02). Interestingly, the results did not support a buffering effect of social support on peer victimisation; however, these longitudinal data did support several indirect paths. The results highlight the cyclical relationship between social anxiety and peer victimisation but point to social anxiety as a unidirectional predictor of social support from a close friend during the middle to late childhood years. Early intervention for social anxiety may produce positive downstream effects on both peer victimisation and social support.

Despite the availability of universally delivered evidence-based relational health interventions, their wide-scale translation into practice is slow and unsustained. Measuring implementation outcomes within intervention trials is critical to understand their effectiveness and inform future scaling. This study aimed to determine the extent to which universally delivered relational health interventions measured and reported on implementation outcomes to inform their effectiveness. A secondary analysis of a scoping review examined the extent to which 123 RCT-evaluated relational health intervention studies referred to (1) implementation related theories or frameworks; (2) implementation data collection methods; (3) implementation measures, and; (4) each of twelve implementation outcomes (acceptability, adoption, appropriateness, cost, feasibility, fidelity-adherence, fidelity-dose, fidelity-delivery, fidelity-responsiveness, fidelity-differentiation, penetration and sustainability). The type of implementation trial was also assessed. Seventeen percent of studies reported implementation outcomes as part of the intervention main effects, with the remaining studies (83%) reporting implementation outcomes as a minor sub-analysis (52%), in their discussion only (21%) or not at all (10%). The most frequently reported outcomes were fidelity measures of dose and adherence. Almost a half of the twelve implementation outcomes were not addressed. No studies described an implementation-related theory or framework, and all used non-standardised measures. Greater attention to measuring and reporting implementation outcomes within relational health intervention trials is needed to ensure that critical evidence for replicability and scalability is available to those who are considering implementation in practice. This would facilitate improvements in both intervention implementation and sustainability and importantly, relational health outcomes for children and families.

In this paper, we describe the developmental process of a culturally grounded Moombaki virtual reality (VR) game. We share how Aboriginal children’s drawings have informed the creation of an interactive learning platform for primary school-aged children attending schools in Wadjuk Boodja. The project focused on connecting students to cultural knowledge through immersive storytelling, creative exploration, and collaborative design by using small group yarning circles and game development activities. The aim of the yarning sessions was to identify, explore, and understand the knowledge Aboriginal children had of Aboriginal identity and culture, including protocols, ceremonies, stories, Dreamtime, languages, and traditional practices, and how best to represent these concepts in the cultural learning journey using virtual reality.

Background: Blood glucose management around exercise is challenging for youth with type 1 diabetes (T1D). Previous research has indicated interventions including decision-support aids to better support youth to effectively contextualize blood glucose results and take appropriate action to optimize glucose levels during and after exercise. Mobile health (mHealth) apps help deliver health behavior interventions to youth with T1D, given the use of technology for glucose monitoring, insulin dosing, and carbohydrate counting. Objective: We aimed to develop a novel prototype mHealth app to support exercise management among youth with T1D, detail the application of a co-design process and design thinking principles to inform app design and development, and identify app content and functionality that youth with T1D need to meet their physical activity goals. Methods: A co-design approach with a user-centered design thinking framework was used to develop a prototype mHealth app “acT1ve” during the 18-month design process (March 2018 to September 2019). To better understand and respond to the challenges among youth with diabetes when physically active, 10 focus groups were conducted with youth aged 13-25 years with T1D and parents of youth with T1D. Thereafter, we conducted participatory design workshops with youth to identify key app features that would support individual needs when physically active. These features were incorporated into a wireframe, which was critically reviewed by participants. A beta version of “acT1ve” was built in iOS and android operating systems, which underwent critical review by end users, clinicians, researchers, experts in exercise and T1D, and app designers. Results: Sixty youth with T1D, 14 parents, 6 researchers, and 10 clinicians were engaged in the development of “acT1ve.” acT1ve included key features identified by youth, which would support their individual needs when physically active. It provided advice on carbohydrates and insulin during exercise, information on hypoglycemia treatment, pre- and postexercise advice, and an educational food guide regarding exercise management. “acT1ve” contained an exercise advisor algorithm comprising 240 pathways developed by experts in diabetes and exercise research. Based on participant input during exercise, acT1ve provided personalized insulin and carbohydrate advice for exercise lasting up to 60 minutes. It also contains other features including an activity log, which displays a complete record of the end users’ activities and associated exercise advice provided by the app’s algorithm for later reference, and regular reminder notifications for end users to check or monitor their glucose levels. Conclusions: The co-design approach and the practical application of the user-centered design thinking framework were successfully applied in developing “acT1ve.” The design thinking processes allowed youth with T1D to identify app features that would support them to be physically active, and particularly enabled the delivery of individualized advice. Furthermore, app development has been described in detail to help guide others embarking on a similar project. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12619001414101; https://tinyurl.com/mu9jvn2d

Summary: Child obesity is a serious public health challenge affected by both individual choice and societal and environmental factors. The main modifiable risk factors for child obesity are unhealthy eating and low levels of physical activity, both influenced by aspects of the built environment. Coordinated government policy across jurisdictions, developed using strong research evidence, can enable built environments that better support healthy lifestyles. This study reviewed current Australian and Western Australian government policies to understand if and how they address the impact of the built environment on child obesity, physical activity, sedentary behavior, and diet. Current government policy documents related to the built environment and child health were analyzed using the Comprehensive Analysis of Policy on Physical Activity framework. Ten Australian and 31 Western Australian government policy documents were identified. Most referred to the role of the built environment in supporting physical activity. Very few policies mentioned the built environment's role in reducing sedentary behaviors, supporting healthy eating, and addressing obesity. Few recognized the needs of children, and none mentioned children in policy development. Future government policy development should include the voices of children and child‐specific built environment features. Inter‐organizational policies with transparent implementation and evaluation plans are recommended.

BACKGROUND Blood glucose management around exercise is challenging for youth with type 1 diabetes (T1D). Previous research has indicated interventions including decision-support aids to better support youth to effectively contextualize blood glucose results and take appropriate action to optimize glucose levels during and after exercise. Mobile health (mHealth) apps help deliver health behavior interventions to youth with T1D, given the use of technology for glucose monitoring, insulin dosing, and carbohydrate counting. OBJECTIVE We aimed to develop a novel prototype mHealth app to support exercise management among youth with T1D, detail the application of a co-design process and design thinking principles to inform app design and development, and identify app content and functionality that youth with T1D need to meet their physical activity goals. METHODS A co-design approach with a user-centered design thinking framework was used to develop a prototype mHealth app “acT1ve” during the 18-month design process (March 2018 to September 2019). To better understand and respond to the challenges among youth with diabetes when physically active, 10 focus groups were conducted with youth aged 13-25 years with T1D and parents of youth with T1D. Thereafter, we conducted participatory design workshops with youth to identify key app features that would support individual needs when physically active. These features were incorporated into a wireframe, which was critically reviewed by participants. A beta version of “acT1ve” was built in iOS and android operating systems, which underwent critical review by end users, clinicians, researchers, experts in exercise and T1D, and app designers. RESULTS Sixty youth with T1D, 14 parents, 6 researchers, and 10 clinicians were engaged in the development of “acT1ve.” acT1ve included key features identified by youth, which would support their individual needs when physically active. It provided advice on carbohydrates and insulin during exercise, information on hypoglycemia treatment, pre- and postexercise advice, and an educational food guide regarding exercise management. “acT1ve” contained an exercise advisor algorithm comprising 240 pathways developed by experts in diabetes and exercise research. Based on participant input during exercise, acT1ve provided personalized insulin and carbohydrate advice for exercise lasting up to 60 minutes. It also contains other features including an activity log, which displays a complete record of the end users’ activities and associated exercise advice provided by the app’s algorithm for later reference, and regular reminder notifications for end users to check or monitor their glucose levels. CONCLUSIONS The co-design approach and the practical application of the user-centered design thinking framework were successfully applied in developing “acT1ve.” The design thinking processes allowed youth with T1D to identify app features that would support them to be physically active, and particularly enabled the delivery of individualized advice. Furthermore, app development has been described in detail to help guide others embarking on a similar project. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12619001414101; https://tinyurl.com/mu9jvn2d

Co-design and youth participatory action research are promising methodologies for increasing youth engagement in well-being interventions. The current study included 10 recent high school graduates employed as youth advisors to co-design a youth-friendly positive psychology intervention targeting the post-school transition. The youth advisors received foundational training in positive psychology, psychological needs theory and emerging adulthood. They held regular meetings to develop a Positive Transitions programme (PTP) text messaging intervention, informed by discussion of key themes, issues and relevant practical tips. This paper aims to examine the co-design process from the perspective of the youth advisors. Each youth advisor completed a survey, and six of the advisors also participated in a focus group exploring their co-design experiences. Youth advisors noted a range of personal benefits from the co-design experience including learning, enjoyment, teamwork, achievement, and pride. Areas for improvement included clarity of the project scope and the provision of support and feedback. Insights from this process are discussed, with the aim of guiding future work seeking to design youth-friendly well-being interventions.

The goal of the article is to support the early childhood sector’s efforts to increase the salience of early childhood as a social issue and change policy and practice to better support young children and their families. Cultural models shape how people think about social issues and support solutions. Changing how issues are framed—how they are presented, positioned and focused—can help shift these models and facilitate culture change. Using mixed methods research, we identified cultural models that members of the Australian public use to think about early childhood and compared these mindsets to concepts that the sector seeks to advance. This revealed a set of gaps in understanding that make it difficult for the sector to advance its agenda. We then designed and tested framing strategies to address these challenges and improve the salience of early childhood as a social issue, increase understanding of key concepts and build support for policies, programs and interventions. Findings point to strategies that advocates, service providers and funders can use to communicate more effectively about the importance of the early years.